Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SUMMED2 > GI-IBD > Flashcards

GI-IBD Flashcards

1
Q

Is IBD and IBS the same?

A 
NO
IBD- chronic recurring inflammation of GI tract d/t dysregulated immune response industrialized, urban, north
Ulcerative Colitis
Chron's
Indeterminate colitis- overlap of both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which condition is biomodal?

A

M UC young and late
F CD young and late

Causes; genetic, mucosal immune system dysregulated, Environmental Triggers
HIgh protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which disease has bloody diarrhea from the mucosa and submucosa from ALWAYS rectum to proximal colon +/-?

A 
Ulcerative Colitis
10-20 bowels/day
Frequency, urgency
Tenesmus- crampy rectal sensation prior to defecation w/o stool
Nocturnal bowel movements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What sx of UC may overlap with other GI?

A

Abdominal pain
Fatigue
Anorexia
Wt. Loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does a colonoscopy discover as a diagnosis of UC?

A

erythema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mr. Rex c/c of bloody diarrhea 10x /day, loss of 10lbs recently. During colonoscopy he had 100% rectal damage, confluent to proximal colon. NO perianal fissures or strictures.

A

Ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the protective factors benefit of UC?

A

smoking

appendectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is the microbiome different in IBD?

A

UC and CD less diversity in bacteria

Depleted microbiome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are benefits of microbiome?

A

metabolize CHO
Vit and hormone production
Immune develop
mucosa protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which drug dec. inflammation in wall of intestine primarily for UC?

A

5-Aminosalicylates 5-ASA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which disease affects from mouth-anus, interspersed, skip lesions, but healthy tissue in other locations?

A 
Chron's Dz
LOC
Perianal- MC- abscess, fissures, fistulas
Illeocolonic MC
Small bowel
Colon
Stomach/duoden LC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are lining mechanisms due to deep punched out ulcers ?

A

Abscess - GI tract getting weak- If it doesn’t find an opening to relieve the pressure
Fistula- finds opening to relieve the pressure
Stricture- narrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is fissures, low/high fistulas, abscess, anorectal strictures, hemorrhoids and anal ulcers?

A

Perianal Disease

1/3 develop prior to CD sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are classic sx assoc with Chron’s Dz?

A
  1. Diarrhea
  2. Blood in stool
  3. Abdominal pain
  4. Weight loss, weakness and anorexia
    DX- determine CD vs UC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ms. Beta has noticed her daughter has started to avoid raw vegetables, salad, broccoli? What and why might this be.

A 
Stricturing in SMALL bowel assoc with Chrons– nausea, vomiting, bloating, food aversion
Diarrhea, usually non-bloody
Abdominal pain
Fever/weight loss/anorexia
Malabsorption/malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ms. Beta fever, malaise, weight loss, wt/ diarrhea and bloating. What is concerning with this sx

A

Perforation

SX- Fever unknown orgin, Sepis

17
Q

What will colonoscopy, CT or MRI reveal?

A

DX for Chron’s vs. UC
Transmural ulcers- include all layers
lesion dispersed
Punched out ulcers
Damage-Rectal +/- , perianal, strictures, illeum involved
Patchy distribution of inflammation in GI tract

18
Q

What is most challenging with IBD tx?

A 
Flares
Pt stop meds until flare
Inconsistent btwn pt
Cost
ADE
19
Q

What are goals with TX

A

Maintain clinical remission- cut down bowel 20 to 4 per day, no blood in the stool

iii. Heal mucosal lesions
iv. Decrease hospitalization/surgery
v. Minimize disease and treatment-related complications

20
Q

What influence the response of TX for IBD?

A

i. Ulcerative colitis or Crohn’s disease
ii. severity
iii. Anatomic location
iv. Previous response to medications
v. Side effects of medications
vi. Comorbidities
vii. Patient preferences

21
Q

What agent are used for mild IBD, Modifies activity of immune system to reduce inflammation.

A 
Immunomodulators:
CHRONIC IBD prior to Steroids
a.	6-mercaptopurine (6-MP)
b.	Azathioprine (AZA, prodrug of 6-MP)
c.	Methotrexate (MTX)
Used in IBD for 30y ,*** Slow onset of action (~ 6 months)

ADE

a. **Infectious complications
b. Myelosuppression 5%
c. Transaminase elevation- Cholestatic hepatitis <1%
d. Pancreatitis 3%
e. Fever/myalgia 2%
f. Nausea/dyspepsia up to 20%
g. Lymphoma rare
h. Increase in non-melanoma skin cancers
i. Up to 20% d/c

22
Q

What is use to treat MOD or MILD IBD?

A

Budesonide- induce remisson, not maintenance. Affinity for GI tract
Less ADE than Prednisone

***Corticosteroid Prednisone- acute flares of IBD
 ADE
Short-Term:
i.	Weight gain
ii.	Fluid retention
iii.	Sleep disturbance
iv.	Mood swings
v.	Acne

b. Long-Term:
i. Infection
ii. Bone loss / osteoporosis
iii. Cataracts / Glaucoma
iv. Skin fragility
v. Hypertension
vi. Diabetes

23
Q

Which agents are used for severe IBD along with surgery, and target TNF and it neutralizes it so it can’t propagate inflammation?

A 
Biologics- Anti-TNF 
Injections-
Remicade,
Humira, 
Cimzia, 
Simponi

40% response, habituate
Cost>15K/yr

24
Q

WHat molecule in the body is a key factor in inflammation. neutralize this molecule increase you risk to infection b/c our inflammatory response is not there

a. TB reactivation
b. Hepatitis B reactivation
c. Reactivation of opportunistic infections
d. Autoimmunity
e. Malignancy / lymphoma
f. Neurologic events/ demyelination syndromes
g. Cardiovascular events
h. Deaths

A

Tumor necrosis factor

25
Q

Mr. Pepsy diarrhea 10x/day, at night as well, is ambulating w/o pain. NO abdominal ttp, mass or obstruction. What Tx do you start?

A

MILD IBD

TX: 5 -ASA 1st Line

26
Q

Mr. Cereal is not responding to TX. Febrile, wt loss, anemia. Abdominal ttp. N/V QOW. What Tx do you start?

A

MOD-Severe
Immunmoudlators- 6-MP, AZA, MTX
Prednisone
Budesonide

27
Q

Mrs. BreadnButter syp are persistent even with Prednisone. She is febrile, +rebound, wasting away. Colonoscpy show absess.

A

SEVERE IBD, Chron’s
Anti TNF- Humira etc. Biologics
Surgery

28
Q 
Will the following TX help IBD?Diet – Mediterranean diet, low FODMAPs diet 
• Supplements – Tumeric! 
• Marijuana? 
• Fecal transplant? 
• Helminth therapy? 
• Surgery
A

Maybe

SUMMED2 (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions